title: Treatment of chronic hepatitis C virus infection after liver transplantation.
abstract: Chronic hepatitis C virus infection is a leading cause of end stage liver disease and one of the leading indications for liver transplantation. Furthermore, hepatitis C virus recurrence is universal post-transplant leading to decreased graft and patient survival. Recurrent disease related to hepatitis C virus can lead to between 20 and 30% of patients developing recurrent cirrhosis within 5 years. Treatment options with antiviral therapy are limited and are associated with a significant side-effect profile, suboptimal tolerability and inferior response rates. Attention has therefore turned to strategies that can reduce hepatitis C virus recurrence rates post-transplant. Approximately only 30% of patients will achieve a sustained virologic response with current therapy with pegylated interferon and ribavirin. Successful hepatitis C virus eradication is the only factor associated with improved graft and patient survival post liver transplantation. Here we provide an overview of antiviral treatment in patients in the transplant arena and the potential opportunities and challenges with the introduction of new directly acting antivirals in G1 patients.
authors.affiliation: Institute of Liver Studies, King's College Hospital, London, UK. Electronic address: kosh.agarwal@kcl.ac.uk.
authors.forename: Kosh
authors.initials: K
authors.lastname: Agarwal
authors.forename: Ashley
authors.initials: A
authors.lastname: Barnabas
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004347:Drug Interactions; D058625:End Stage Liver Disease / Q000601:surgery; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000517:prevention & control*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000821:virology; D016031:Liver Transplantation; D009842:Oligopeptides / Q000627:therapeutic use; D011392:Proline / Q000031:analogs & derivatives / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D055502:Secondary Prevention
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; D012254:Ribavirin; C486464:telaprevir; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D007372:Interferons; D011392:Proline
keywords: Boceprevir; DAA; Fibrosis; HCV; Hepatitis C virus; LADR; LT; Liver transplantation; Low accelerating dose regimen; PEG-IFN; PI; PR; Pegylated interferon; R; Ribavirin; Telaprevir; directly acting antivirals; hepatitis C virus; liver transplantation; low accelerating dose regimen; pegylated interferon; pegylated interferon and ribavirin; protease inhibitor; ribavirin